The effect of high rates of bacterial sexually transmitted infections on hiv incidence in a cohort of black and white men who have sex with men in Atlanta, Georgia

Colleen F. Kelley, Adam S. Vaughan, Nicole Luisi, Travis H. Sanchez, Laura F. Salazar, Paula M. Frew, Hannah L.F. Cooper, Ralph DiClemente, Carlos Del Rio, Patrick S. Sullivan, Eli S. Rosenberg

Research output: Contribution to journalArticle

Abstract

Data reporting sexually transmitted infection (STI) incidence rates among HIV-negative U.S. men who have sex with men (MSM) are lacking. In addition, it is difficult to analyze the effect of STI on HIV acquisition given that sexual risk behaviors confound the relationship between bacterial STIs and incident HIV. The InvolveMENt study was a longitudinal cohort of black and white HIV-negative, sexually active MSM in Atlanta who underwent routine screening for STI and HIV and completed behavioral questionnaires. Age-adjusted incidence rates were calculated for urethral and rectal Chlamydia (CT), gonorrhea (GC), and syphilis, stratified by race. Propensity-score-weighted Cox proportional hazards models were used to estimate the effect of STI on HIV incidence and calculate the population attributable fraction (PAF) for STI. We included 562 HIV-negative MSM with 843 person-years of follow-up in this analysis. High incidence rates were documented for all STIs, particularly among black MSM. Having a rectal STI was significantly associated with subsequent HIV incidence in adjusted analyses (aHR 2.7; 95% CI 1.2, 6.4) that controlled for behavioral risk factors associated with STI and HIV using propensity score weights. The PAF for rectal STI was 14.6 (95% CI 6.8, 31.4). The high incidence of STIs among Atlanta MSM and the association of rectal STI with HIV acquisition after controlling for behavioral risk underscore the importance of routine screening and treatment for STIs among sexually active MSM. Our data support targeting intensive HIV prevention interventions, such as preexposure chemoprophylaxis (PrEP), for Atlanta MSM diagnosed with rectal STIs.

Original languageEnglish (US)
Pages (from-to)587-592
Number of pages6
JournalAIDS Research and Human Retroviruses
Volume31
Issue number6
DOIs
StatePublished - Jun 1 2015

Fingerprint

Sexually Transmitted Diseases
HIV
Incidence
Propensity Score
hydroquinone
Chlamydia
Gonorrhea
Chemoprevention
Syphilis
Risk-Taking
Proportional Hazards Models
Sexual Behavior
Population
Research Design

ASJC Scopus subject areas

  • Immunology
  • Virology
  • Infectious Diseases

Cite this

The effect of high rates of bacterial sexually transmitted infections on hiv incidence in a cohort of black and white men who have sex with men in Atlanta, Georgia. / Kelley, Colleen F.; Vaughan, Adam S.; Luisi, Nicole; Sanchez, Travis H.; Salazar, Laura F.; Frew, Paula M.; Cooper, Hannah L.F.; DiClemente, Ralph; Del Rio, Carlos; Sullivan, Patrick S.; Rosenberg, Eli S.

In: AIDS Research and Human Retroviruses, Vol. 31, No. 6, 01.06.2015, p. 587-592.

Research output: Contribution to journalArticle

Kelley, Colleen F. ; Vaughan, Adam S. ; Luisi, Nicole ; Sanchez, Travis H. ; Salazar, Laura F. ; Frew, Paula M. ; Cooper, Hannah L.F. ; DiClemente, Ralph ; Del Rio, Carlos ; Sullivan, Patrick S. ; Rosenberg, Eli S. / The effect of high rates of bacterial sexually transmitted infections on hiv incidence in a cohort of black and white men who have sex with men in Atlanta, Georgia. In: AIDS Research and Human Retroviruses. 2015 ; Vol. 31, No. 6. pp. 587-592.
@article{c07c3723d4434a17838d7453de6e25bb,
title = "The effect of high rates of bacterial sexually transmitted infections on hiv incidence in a cohort of black and white men who have sex with men in Atlanta, Georgia",
abstract = "Data reporting sexually transmitted infection (STI) incidence rates among HIV-negative U.S. men who have sex with men (MSM) are lacking. In addition, it is difficult to analyze the effect of STI on HIV acquisition given that sexual risk behaviors confound the relationship between bacterial STIs and incident HIV. The InvolveMENt study was a longitudinal cohort of black and white HIV-negative, sexually active MSM in Atlanta who underwent routine screening for STI and HIV and completed behavioral questionnaires. Age-adjusted incidence rates were calculated for urethral and rectal Chlamydia (CT), gonorrhea (GC), and syphilis, stratified by race. Propensity-score-weighted Cox proportional hazards models were used to estimate the effect of STI on HIV incidence and calculate the population attributable fraction (PAF) for STI. We included 562 HIV-negative MSM with 843 person-years of follow-up in this analysis. High incidence rates were documented for all STIs, particularly among black MSM. Having a rectal STI was significantly associated with subsequent HIV incidence in adjusted analyses (aHR 2.7; 95{\%} CI 1.2, 6.4) that controlled for behavioral risk factors associated with STI and HIV using propensity score weights. The PAF for rectal STI was 14.6 (95{\%} CI 6.8, 31.4). The high incidence of STIs among Atlanta MSM and the association of rectal STI with HIV acquisition after controlling for behavioral risk underscore the importance of routine screening and treatment for STIs among sexually active MSM. Our data support targeting intensive HIV prevention interventions, such as preexposure chemoprophylaxis (PrEP), for Atlanta MSM diagnosed with rectal STIs.",
author = "Kelley, {Colleen F.} and Vaughan, {Adam S.} and Nicole Luisi and Sanchez, {Travis H.} and Salazar, {Laura F.} and Frew, {Paula M.} and Cooper, {Hannah L.F.} and Ralph DiClemente and {Del Rio}, Carlos and Sullivan, {Patrick S.} and Rosenberg, {Eli S.}",
year = "2015",
month = "6",
day = "1",
doi = "10.1089/aid.2015.0013",
language = "English (US)",
volume = "31",
pages = "587--592",
journal = "AIDS Research and Human Retroviruses",
issn = "0889-2229",
publisher = "Mary Ann Liebert Inc.",
number = "6",

}

TY - JOUR

T1 - The effect of high rates of bacterial sexually transmitted infections on hiv incidence in a cohort of black and white men who have sex with men in Atlanta, Georgia

AU - Kelley, Colleen F.

AU - Vaughan, Adam S.

AU - Luisi, Nicole

AU - Sanchez, Travis H.

AU - Salazar, Laura F.

AU - Frew, Paula M.

AU - Cooper, Hannah L.F.

AU - DiClemente, Ralph

AU - Del Rio, Carlos

AU - Sullivan, Patrick S.

AU - Rosenberg, Eli S.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Data reporting sexually transmitted infection (STI) incidence rates among HIV-negative U.S. men who have sex with men (MSM) are lacking. In addition, it is difficult to analyze the effect of STI on HIV acquisition given that sexual risk behaviors confound the relationship between bacterial STIs and incident HIV. The InvolveMENt study was a longitudinal cohort of black and white HIV-negative, sexually active MSM in Atlanta who underwent routine screening for STI and HIV and completed behavioral questionnaires. Age-adjusted incidence rates were calculated for urethral and rectal Chlamydia (CT), gonorrhea (GC), and syphilis, stratified by race. Propensity-score-weighted Cox proportional hazards models were used to estimate the effect of STI on HIV incidence and calculate the population attributable fraction (PAF) for STI. We included 562 HIV-negative MSM with 843 person-years of follow-up in this analysis. High incidence rates were documented for all STIs, particularly among black MSM. Having a rectal STI was significantly associated with subsequent HIV incidence in adjusted analyses (aHR 2.7; 95% CI 1.2, 6.4) that controlled for behavioral risk factors associated with STI and HIV using propensity score weights. The PAF for rectal STI was 14.6 (95% CI 6.8, 31.4). The high incidence of STIs among Atlanta MSM and the association of rectal STI with HIV acquisition after controlling for behavioral risk underscore the importance of routine screening and treatment for STIs among sexually active MSM. Our data support targeting intensive HIV prevention interventions, such as preexposure chemoprophylaxis (PrEP), for Atlanta MSM diagnosed with rectal STIs.

AB - Data reporting sexually transmitted infection (STI) incidence rates among HIV-negative U.S. men who have sex with men (MSM) are lacking. In addition, it is difficult to analyze the effect of STI on HIV acquisition given that sexual risk behaviors confound the relationship between bacterial STIs and incident HIV. The InvolveMENt study was a longitudinal cohort of black and white HIV-negative, sexually active MSM in Atlanta who underwent routine screening for STI and HIV and completed behavioral questionnaires. Age-adjusted incidence rates were calculated for urethral and rectal Chlamydia (CT), gonorrhea (GC), and syphilis, stratified by race. Propensity-score-weighted Cox proportional hazards models were used to estimate the effect of STI on HIV incidence and calculate the population attributable fraction (PAF) for STI. We included 562 HIV-negative MSM with 843 person-years of follow-up in this analysis. High incidence rates were documented for all STIs, particularly among black MSM. Having a rectal STI was significantly associated with subsequent HIV incidence in adjusted analyses (aHR 2.7; 95% CI 1.2, 6.4) that controlled for behavioral risk factors associated with STI and HIV using propensity score weights. The PAF for rectal STI was 14.6 (95% CI 6.8, 31.4). The high incidence of STIs among Atlanta MSM and the association of rectal STI with HIV acquisition after controlling for behavioral risk underscore the importance of routine screening and treatment for STIs among sexually active MSM. Our data support targeting intensive HIV prevention interventions, such as preexposure chemoprophylaxis (PrEP), for Atlanta MSM diagnosed with rectal STIs.

UR - http://www.scopus.com/inward/record.url?scp=84925314768&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925314768&partnerID=8YFLogxK

U2 - 10.1089/aid.2015.0013

DO - 10.1089/aid.2015.0013

M3 - Article

C2 - 25719950

AN - SCOPUS:84925314768

VL - 31

SP - 587

EP - 592

JO - AIDS Research and Human Retroviruses

JF - AIDS Research and Human Retroviruses

SN - 0889-2229

IS - 6

ER -